Individual provider Active NPI

Eid Lahoud

  • General Practice Dentistry
  • Huntsville, TX
National Provider Identifier
1295144012
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30367 Issued in TX
Practice address
3011 Highway 30 W
Suite 101C
Huntsville, TX 77340-3534
Phone
(936) 294-0400
NPI assigned
Aug 6, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30367 TX Primary

Addresses

Primary practice location

3011 Highway 30 W
Suite 101C
Huntsville, TX 77340-3534

Mailing address

2050 E Algonquin Rd
610
Schaumburg, IL 60173-4144
Phone (847) 701-1457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150808015887 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1951615608

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30367TXMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1295144012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD",
            "address_2": "610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734144",
            "telephone_number": "847-701-1457",
            "fax_number": "847-496-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 HIGHWAY 30 W",
            "address_2": "SUITE 101C",
            "city": "HUNTSVILLE",
            "state": "TX",
            "postal_code": "773403534",
            "telephone_number": "936-294-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAHOUD",
        "first_name": "EID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-06",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "30367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, TX

Sources for this page

Verify at the official NPI Registry.